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AFTER A DECADE, GLOBAL AIDS PROGRAM LOOKS AHEAD
Tuesday, 21 May 2013 08:40 Published in Health & FitnessThe President's Emergency Plan for AIDS Relief grew out of an unlikely partnership between President George W. Bush and lawmakers led by the Congressional Black Caucus. It has come to represent what Washington can do when it puts politics aside - and what America can do to make the world a better place.
President Barack Obama, speaking at the recent dedication of Bush's presidential library, praised the compassion Bush showed in "helping to save millions of lives and reminding people in some of the poorest corners of the globe that America cares."
House Democratic leader Nancy Pelosi said of Bush in a statement that "while many events may distinguish his presidency, his devotion to combatting the scourge of HIV/AIDS will certainly define his legacy."
The AIDS program's future, however, is uncertain. Obama has upped the stakes, speaking in his State of the Union address this year of "realizing the promise of an AIDS-free generation." But funding for the relief plan's bilateral efforts has dipped in recent years and it's doubtful that Congress, in its current budget-cutting mood, will reverse that trend when the current five-year program expires later this year.
The AIDS program is also trying to find a balance between its goals of reaching more people with its prevention and treatment programs and turning over more responsibility to the host nations where it operates.
"This has been an incredible achievement," said Rep. Barbara Lee, D-Calif., a senior Congressional Black Caucus member who played major roles both in passing the original 2003 act and its 2008 renewal that significantly increased funding for AIDS, malaria and tuberculosis treatment in Africa and other areas of the developing world. She spoke of the more than 5 million people now receiving life-saving antiretroviral treatment and 11 million pregnant women who received HIV testing and counseling last year. "But I'm worried that with any type of level-funding or cuts we'll go backward," she said.
The 2008 act more than tripled funding from the 2003 measure, approving $48 billion over five years for bilateral and global AIDS programs, malaria and tuberculosis. It also ended U.S. policy making it almost impossible for HIV-positive people to get visas to enter the country.
The AIDS program was the largest commitment ever by a nation to combat a single disease internationally. According to the U.N.'s UNAIDS and the Kaiser Family Foundation, in 2011 the United States provided nearly 60 percent of all international AIDS assistance.
A decade ago, almost no one in sub-Saharan Africa was receiving antiretroviral treatment. By 2008, the AIDS program had boosted that number to 1.7 million. As of last year it was 5.1 million.
The State Department says the program last year also helped provide treatment to some 750,000 HIV-positive pregnant women, allowing about 230,000 infants to be born HIV-free, supported 2 million male circumcisions and directly supported HIV testing and counseling for 46.5 million.
"This is a remarkable story that the American people should know about," Kimberly Scott of the Institute of Medicine, which recently completed an evaluation of the AIDS program, said at a forum sponsored by the Kaiser Family Foundation and the CSIS Global Health Policy Center.
According to UNAIDS, the number of people living with HIV has leveled off, standing at about 34 million at the end of 2011. New infections that year reached 2.5 million, down 20 percent from 2001. AIDS-related deaths were 1.7 million, down from 2.3 million in 2005.
Jennifer Kates, director of global health and HIV policy at Kaiser, said most countries where the program operates have yet to reach the "tipping point," where new infections occurring in a year are less than the increase in people receiving treatment. Among the success stories were Ethiopia, where the 40,000 going on treatment in 2011 was almost four times the new infections. Still with a long way to go was Nigeria, which that year had 270,000 new HIV infections and a 57,000 increase in those getting treatment.
Chris Collins, director of public policy at amfAR, The Foundation for AIDS Research, also warned of potential repercussions as the AIDS program shifts from being an emergency response to the AIDS epidemic to a more supportive role for country-based health programs.
"The countries themselves largely are avoiding the important role that key populations play in epidemics," he said, referring to gay men, those injecting drugs and sex workers. These groups face discrimination and criminal charges in many cases, and 90 percent of the money to help them now comes from external sources.
Collins also spoke of the "huge mismatch" between the positive science and rhetoric on fighting AIDS and the money available. Since 2009 the funding for bilateral and global HIV and AIDS programs has largely stalled.
Kaiser's Kates said that while there's still bipartisan support for the AIDS program in Congress, "the big question is will the financing be there to reach the goals" of treating more people and advancing toward that AIDS-free generation. "The challenge right now is that the global economic climate is different, the U.S. climate is different, but the need is still great."
© 2013 THE ASSOCIATED PRESS. ALL RIGHTS RESERVED. THIS MATERIAL MAY NOT BE PUBLISHED, BROADCAST, REWRITTEN OR REDISTRIBUTED. Learn more about our PRIVACY POLICY and TERMS OF USE.
The report released by the Interior Department's Office of Inspector General found that park officials responded to last summer's outbreak appropriately and within department policy.
"When the outbreak was identified, NPS mobilized to contain and remediate the outbreak and to prevent further outbreaks," Mary Kendall, a deputy inspector general, wrote in a letter attached to the report.
Still, the report found that current policy didn't require park officials to approve design changes made to the "Signature tent cabins" by concessionaire Delaware North Companies Parks and Resorts, which added rafters and wall studs to the structures.
Investigators determined that deer mice, which can carry the illness, nested inside the double walls of the new tents in Yosemite's family friendly Curry Village.
At least eight of the nine tourists who fell ill stayed in the tent cabins.
Because the changes to the cabins were considered routine maintenance, current park service policy did not require prior approval, the report found.
The report also recommended that the park service begin cyclical pest monitoring and inspections of all public accommodations.
While there is a current pest monitoring program at Yosemite, Delaware North was responsible for Curry Village, which was not considered at high risk for hantavirus.
The company issued a statement late Monday saying it would follow the recommendations in the report.
"DNC Parks & Resorts at Yosemite has consistently worked hand-in-hand with the National Park Service and public health officials on this issue," spokeswoman Lisa Cesaro said in the statement. "The Signature Tent Cabins have been removed from Curry Village. We are following the recommendations by the National Park Service, which were developed in consultation with the California Department of Public Health and the Centers for Disease Control and Prevention."
Prior to the outbreak, Delaware only responded to pests in the cabins when visitors or housekeeping staff complained, the report said.
© 2013 THE ASSOCIATED PRESS. ALL RIGHTS RESERVED. THIS MATERIAL MAY NOT BE PUBLISHED, BROADCAST, REWRITTEN OR REDISTRIBUTED. Learn more about our PRIVACY POLICY and TERMS OF USE.
TOP IRS OFFICIAL DIDN'T REVEAL TEA PARTY TARGETING
Tuesday, 14 May 2013 07:57 Published in National NewsThe IRS said Monday that Miller was first informed on May, 3, 2012, that applications for tax-exempt status by tea party groups were inappropriately singled out for extra, sometimes burdensome scrutiny.
At least twice after the briefing, Miller wrote letters to members of Congress to explain the process of reviewing applications for tax-exempt status without revealing that tea party groups had been targeted. On July 25, 2012, Miller testified before the House Ways and Means oversight subcommittee but again was not forthcoming on the issue — despite being asked about it.
At the hearing, Rep. Kenny Marchant, R-Texas, told Miller that some politically active tax-exempt groups in his district had complained about being harassed. Marchant did not explicitly ask if tea party groups were being targeted. But he did ask how applications were handled.
Miller responded, "We did group those organizations together to ensure consistency, to ensure quality. We continue to work those cases," according to a transcript on the committee's website.
He added, "It is my hope that some of the noise that we heard earlier this year has abated as we continue to work through these cases."
Earlier, Rep. Charles Boustany, R-La., had raised concerns with the IRS about complaints that tea party groups were being harassed. Boustany specifically mentioned tea party groups in his inquiry.
But in a June 15, 2012, letter to Boustany, Miller gave a generic response. He said that when the IRS saw an increase in applications from groups that were involved in political activity, the agency "took steps to coordinate the handling of the case to ensure consistency."
He added that agents worked with tax law experts "to develop approaches and materials that could be helpful to the agents working the cases."
Miller did not mention that in 2011, those materials included a list of words to watch for, such as "tea party" and "patriot." He also didn't disclose that in January 2012, the criteria for additional screening was updated to include references to the Constitution or the Bill of Rights.
"They repeatedly failed to disclose and be truthful about what they were doing," said Rep. Dave Camp, R-Mich., chairman of the House Ways and Means Committee.
Camp's committee is holding a hearing on the issue Friday and Miller is scheduled to testify.
"We are going to need to find out how much he knew," Camp said of Miller.
The Senate Finance Committee announced Monday that it will join a growing list of congressional committees investigating the matter.
The IRS apologized Friday for what it acknowledged was "inappropriate" targeting of conservative political groups during the 2012 election to see whether they were violating their tax-exempt status. In some cases, the IRS acknowledged, agents inappropriately asked for lists of donors.
The agency blamed low-level employees in a Cincinnati office, saying no high-level officials were aware.
When members of Congress repeatedly raised concerns with the IRS about complaints that tea party groups were being harassed last year, a deputy IRS commissioner took the lead in assuring lawmakers that the additional scrutiny was a legitimate part of the screening process.
That deputy commissioner was Miller, who is now the acting head of the agency.
Camp and other members of the Ways and Means Committee sent at least four inquiries to the IRS, starting in June 2011. Utah Sen. Orrin Hatch, the top Republican on the Senate Finance Committee, sent three inquiries. And Rep. Darrell Issa, R-Calif., chairman of the House oversight committee, sent at least one.
None of the responses they received from the IRS acknowledged that conservative groups had ever been targeted, including a response to Hatch dated Sept. 11, 2012 — four months after Miller had been briefed.
In several letters to members of Congress, Miller went into painstaking detail about how applications for tax-exempt status were screened. But he never mentioned that conservative groups were being targeted, even though people working under him knew as early as June 2011 that tea party groups were being targeted, according to an upcoming report by the agency's inspector general.
"It is almost inconceivable to imagine that top officials at the IRS knew conservative groups were being targeted but chose to willfully mislead the committee's investigation into this practice," Camp said. "This revelation goes against the very principles of free speech and liberty upon which this country was founded, and the blatant disregard for which the agency has treated Congress and the American taxpayer raises serious concerns about leadership at the IRS."
The IRS issued a statement Monday saying that Miller had been briefed on May 3, 2012 "that some specific applications were improperly identified by name and sent to the (exempt organizations) centralized processing unit for further review." That was the unit in Cincinnati that handled the tea party applications.
Miller became acting commissioner in November, after Commissioner Douglas Shulman completed his five-year term. Shulman had been appointed by President George W. Bush.
On June 29, 2011, Lois G. Lerner, who heads the IRS division that oversees tax-exempt organizations, learned at a meeting that groups were being targeted, according to a draft of the report by the Treasury inspector general for tax administration.
At the meeting, Lerner was told that groups with "Tea Party," ''Patriot" or "9/12 Project" in their names were being flagged for additional and often burdensome scrutiny, the report says. Lerner instructed agents to change the criteria for flagging groups "immediately."
However, when Lerner responded to inquiries from the House oversight committee, she didn't mention the fact that tea party groups had ever been targeted. Her responses included 45-page letters in May 2012 to Rep. Darrell Issa, R-Calif., who chairs the committee, and Rep. Jim Jordan, R-Ohio, who chairs a subcommittee.
Lerner also met twice with staff from the House Ways and Means oversight subcommittee to discuss the issue, in March and in May 2012, according to a timeline constructed by committee staff. She didn't mention at either meeting that conservative groups had been targeted, according to the timeline.
"Knowing what we know now, the IRS was at best being far from forth coming, or at worst, being deliberately dishonest with Congress," Hatch said Monday.
On Monday, President Barack Obama said he first learned about the issue from news reports on Friday. White House spokesman Jay Carney said the White House counsel's office was alerted the week of April 22 that the inspector general was finishing a report concerning the IRS office in Cincinnati. But, he said, the counsel's office did not get the report and the president did not learn the focus until Friday.
"If, in fact, IRS personnel engaged in the kind of practices that had been reported on and were intentionally targeting conservative groups, then that's outrageous and there's no place for it," Obama said Monday at a press conference. "And they have to be held fully accountable, because the IRS as an independent agency requires absolute integrity, and people have to have confidence that they're applying it in a non-partisan way, applying the laws in a non-partisan way."
___ Associated Press reporters Jim Abrams and Henry C. Jackson contributed to this report.
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